Weight Management Medicine Options 2019 - Veterans Affairs

Weight ManagementMedicine OptionsThis booklet is designed to help youcompare your options for weightmanagement medicine.Who is a good candidate for weightmanagement medicine?If you are participating in a lifestyle changeprogram (such as the MOVE! WeightManagement Program for Veterans) butare not meeting your weight loss goal: And if you have a body-mass index (BMI)of 30 or greater—OR— If your BMI is 27 or greater and you haveone or more health problems (examples:high blood pressure, high cholesterol,type 2 diabetes, obstructive sleep apnea,or osteoarthritis)Will I need other forms of treatmentto help me lose weight?Yes, you will also need to take part in alifestyle change program (such as the MOVE!Program) that includes diet, physical activity,and behavioral counseling.PBM Academic Detailing Service

Phentermine / Topiramate(Qsymia )What does this medicine do?It is a combination of two well-knownmedicines. At low doses, they work very welltogether to help people lose weight alongwith diet and exercise. It helps you think lessabout food and may make it feel lessrewarding to eat food.How much weight can I expect tolose on this medicine? You should lose 1 to 2 pounds a weekif you follow the recommended diet andexercise plan while taking this medicine.In the first 2 weeks, you may lose moreweight. After 3 months, weight loss should beabout 3 to 5% of your starting weight.For example, if you weigh 250 poundswhen you start the medicine, weight lossshould be 8 to 12 pounds in 3 months. If you are not losing weight, talk withyour healthcare team. The dose may bechanged or the medicine may be stopped.How do I take this medicine?The starting dose is one capsule taken bymouth each morning. Your provider mayincrease the dose after 14 days. It is importantthat you follow the medicine instructions.The medicine does not have to be takenwith food.

Possible side effects include: Dry mouthTrouble sleepingFeeling nervousDizzinessFeeling sad Tingling or lighttouching feelingsaround mouthor face Constipation HeadacheLess common but serious side effects: Confusion Muscle pain,cramps, Signs of an allergicor weaknessreaction (examples: Fast heartbeatrash, itching,trouble breathing) Feeling very tired Fast breathingor weakAll medicines can have side effects, althoughnot everyone will have side effects. Talk withyour healthcare team if you notice any sideeffects that you think may be related to thismedicine.Your healthcare team will monitorthe following: Weight Blood pressure Mood Heart rate MOVE! Program Pregnancy test ifor similar programyou are a female of(at least 1 visit perreproductive agemonth)As with all medicines in this booklet,ask your healthcare team if you havequestions or would like to learn more.U.S. DEPARTMENT OF VETERANS AFFAIRS3

Naltrexone / Bupropion ER(Contrave )What does this medicine do?This medicine is a combination of two wellknown medicines that work together to helpyou lose weight. It helps you not feel as hungry,lowers your cravings for foods, and lowersyour feeling that you need to eat. Taking thismedicine may make it easier to follow therecommended diet which should help youlose weight.How much weight can I expectto lose on this medicine? You should lose 1 to 2 pounds a weekif you follow the recommended diet andexercise plan while taking this medicine. Inthe first 2 weeks, you may lose more weight. After 3 months, weight loss shouldbe about 5% of your starting weight.For example, if you weigh 250 poundswhen you start this medicine, weight lossshould be 12 or more pounds in 3 months. If you are not losing weight, talk with yourhealthcare team. The dose may be changedor the medicine may be stopped.How do I take this medicine?The starting dose of this medicine is one tableta day for the first week. Your provider willslowly increase the dose. Do not take with ahigh-fat meal. Do not cut, chew, or crush tablets.Your provider or pharmacist will talk to youmore about how you should take this medicine.4Weight Management Medicine Options

Possible side effects include: Feeling tired orweak Dizziness Problems sleepingif you take themedicine too latein the day Constipation Diarrhea Nausea or upsetstomach Dry mouth HeadacheLess common but serious side effects: Signs of an allergic reaction (examples:rash, itching, or trouble breathing) Signs of high blood pressure (like a verybad headache or dizziness) Signs of liver problems (like dark urine,feeling tired, feeling not hungry, lightcolored stools) Seeing or hearing things that are not there Heartbeat that does not feel normal SeizuresAll medicines can have side effects, althoughnot everyone will have side effects. Talk withyour healthcare team if you notice any sideeffects that you think may be related to thismedicine.Your healthcare team will monitorthe following: WeightBlood pressureHeart beatMood MOVE! Programor similar program(at least 1 visit permonth)U.S. DEPARTMENT OF VETERANS AFFAIRS5

Lorcaserin (Belviq )What does this medicine do?It helps people lose weight along with areduced-calorie diet and increased physicalactivity. It works by decreasing your appetite.Taking this medicine may make it easier tofollow the recommended diet which shouldthen result in weight loss.How much weight can I expectto lose on this medicine? You should lose one-half to 2 poundsa week if you follow the recommendeddiet and exercise plan while taking thismedicine. After 3 months, weight loss shouldbe 3% of your starting weight.For example, if you weigh 250 poundswhen you start this medicine, you shouldlose 8 pounds in 3 months. If you are not losing weight, talk with yourhealthcare team. The medicine may needto be stopped or changed.How do I take this medicine?If you are prescribed the immediate-releaseform of medicine, you will take 1 tablet bymouth 2 times daily. If you are prescribed theextended-release form of this medicine,you will take 1 tablet once daily. Do not crush,chew, or divide the extended-release tablets.Both forms of this medicine may be takenwithout regard to food.6Weight Management Medicine Options

Possible side effects include: Feeling tired orweak Dizziness Nausea or upsetstomach Constipation ordiarrhea Low blood sugar(if you havediabetes) HeadacheLess common but serious side effects: Signs of an allergic reaction (examples:rash, itching, or trouble breathing) Feeling confused New or worse behavior or mood changeslike depression or thoughts of killingyourself Seeing or hearing things that are not there Signs of high blood pressure (like a verybad headache or dizziness) Memory problems or lossAll medicines can have side effects, althoughnot everyone will have side effects. Talk withyour healthcare team if you notice any sideeffects that you think may be related to thismedicine.Your healthcare team will monitorthe following: WeightBlood sugarBlood pressureHeart beatMood MOVE! Programor similar program(at least 1 visit permonth)U.S. DEPARTMENT OF VETERANS AFFAIRS7

Liraglutide (Saxenda )What does this medicine do?This medicine helps people lose weight,along with a reduced-calorie diet andincreased physical activity, by reducinghunger and urge to eat.How much weight can I expectto lose on this medicine? You should lose 1 to 2 pounds a weekif you follow the recommended diet andexercise plan while taking this medicine. After 4 months, weight loss shouldbe 4% of your starting weight.For example, if you weigh 250 poundswhen you start this medicine, weightloss should be 10 pounds in 4 months. If you are not losing weight, talk withyour healthcare team. The dose may bechanged or the medicine may be stopped.How do I take this medicine?This medicine is supplied as a pen to be usedfor injection. You will inject it just under theskin of the upper leg, stomach area, or upperarm once daily. It may be given without regardto meals or time of day. Your provider orpharmacist will teach you how to do thisbefore sending you home.8Weight Management Medicine Options

Possible side effects include: Nausea or vomitingLow blood sugarFast heartbeatHeadacheDizziness Diarrhea orconstipation Feeling tired Stomach ache Injection sitereactionLess common but serious side effects: Signs of an allergic reaction (examples:rash, itching, or trouble breathing) Gallbladder disease Mood changes such as feeling sad orwanting to harm yourself Kidney disease Pancreatitis Thyroid tumorAll medicines can have side effects, althoughnot everyone will have side effects. Talk withyour healthcare team if you notice any sideeffects that you think may be related to thismedicine.Your healthcare team will monitorthe following: WeightBlood pressureHeart rateBlood sugarKidney labsMoodMOVE! Program orsimilar program (at least1 visit per month)U.S. DEPARTMENT OF VETERANS AFFAIRS9

Orlistat (Xenical )What does this medicine do?This medicine helps people lose weight alongwith a reduced-calorie diet by blocking somedietary fat from being absorbed with each meal.How much weight can I expectto lose on this medicine? You should lose one-half to 2 poundsa week if you follow the recommendeddiet and exercise plan while taking thismedicine. In the first 2 weeks, you maylose more weight. After 3 months, weight loss should be3% of your starting weight. For example,if you weigh 250 pounds when you startthis medicine, weight loss should be 8 ormore pounds in 3 months. If you are not losing weight, talk with yourhealthcare team. The dose may be changedor the medicine may be stopped.How do I take this medicine?You will take 1 capsule by mouth withmeals—up to 3 meals per day.This medicine may be takenduring or up to 1 hour afterthe meal. It is recommendedto skip a dose if youskip a meal.10Weight Management Medicine Options

Possible side effects include: Oily diarrhea, especially if excess fat inthe diet Headache May note orange tint to bowel movementsor oil droplets in the toilet More frequent bowel movements Bowel urgency, less warning of needingto have a bowel movement Upset stomach, cramps, gasLess common but serious side effects: Signs of an allergic reaction (examples:rash, itching, or trouble breathing) Signs of liver problems (like dark urine,feeling tired, feeling not hungry, lightcolored stools)All medicines can have side effects, althoughnot everyone will have side effects. Talk withyour healthcare team if you notice any sideeffects that you think may be related to thismedicine.Your healthcare team will monitorthe following: Weight MOVE! Program or similar program(at least 1 visit per month) Other tests may be ordered if you havehealth problems (example: if you havediabetes, your provider will check yourblood sugar)U.S. DEPARTMENT OF VETERANS AFFAIRS11

Visit www.move.va.govfor information about the MOVE!Weight Management Program for Veterans,which includes apps, videos, and handoutsdesigned to support you with your weightmanagement goals.Please contact your healthcare teamwith any questions or concerns, or talk toyour MOVE! Coordinator or VA Providerto find out how to get started.PBM Academic Detailing ServiceJuly 2019IB 10-1160P96922

lose weight. How much weight can I expect to lose on this medicine? You should lose 1 to 2 pounds a week. if you follow the recommended diet and exercise plan while taking this medicine. In the first 2 weeks, you may lose more weight. After 3 months, weight loss should be about 5% of your starting weight. For example, if you weigh 250 .